Papillary Thyroid Cancer
Conditions
Keywords
papillary thyroid cancer, central neck dissection, survival, locoregional control, morbidity
Brief summary
The purpose of this study is to determine whether prophylactic central neck dissection is beneficial for patients with papillary thyroid cancer staged preoperatively as node negative.
Detailed description
Several respected organizations have recently recommended that total thyroidectomy plus prophylactic central neck dissection should be the standard operation for papillary thyroid cancer. However, it is still unclear if this approach has any benefit on survival or locoregional control of the disease. In addition, potential advantages of this more aggressive surgical approach should outweigh the risk of morbidity. The purpose of this retrospective cohort study is to determine whether prophylactic central neck dissection is beneficial for patients with papillary thyroid cancer staged preoperatively as node negative. In this study outcomes of total thyroidectomy versus this plus prophylactic central neck dissection for papillary thyroid cancer are compared in a 10-year follow-up. Patients operated between 1993 and 1997 (n=282) underwent total thyroidectomy alone, whereas patients operated between 1998 and 2002 (n=358) underwent total thyroidectomy plus prophylactic central neck dissection.
Interventions
PROCEDURETotal thyroidectomy
Extracapsular total thyroidectomy
PROCEDURETotal thyroidectomy + prophylactic central neck dissection
Extracapsular total thyroidectomy plus prophylactic central neck dissection
Sponsors
Jagiellonian University
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* a pathological diagnosis of papillary thyroid cancer, * in a patient with negative cervical lymph nodes on pre-, or intraoperative evaluation
Exclusion criteria
* incidental diagnosis of papillary thyroid cancer following hemithyroidectomy and requiring completion thyroidectomy, * one-stage lymph nodes dissection based on therapeutic intent, * previous thyroid surgery, * incomplete follow-up information, * incomplete histopathology report, * ASA grade higher than 3 (American Society of Anesthesiology)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| overall survival | up to 10 years |
| disease-specific survival | up to 10 years |
| locoregional control | up to 10 years |
Secondary
| Measure | Time frame |
|---|---|
| number of patients with negative serum thyroglobulin levels | up to 10 years |
| postoperative morbidity rate (hypoparathyroidism and recurrent laryngeal nerve injury). | up to 12 months |
Countries
Poland
Outcome results
None listed